Associations Between Extreme Weather Events and Resource Insecurities With HIV Vulnerabilities and Biomedical HIV Prevention Outcomes Among Adolescent Girls and Young Women in Kenya: A Cross-Sectional Analysis

Objectives We examined associations between extreme weather events (EWE), resource insecurities, and HIV vulnerabilities among a purposive sample of adolescent girls and young women (AGYW) aged 16 to 24 in Nairobi and Kisumu, Kenya. Methods We conducted multivariable logistic/linear regression on cross-sectional survey data to assess associations between EWE exposure, food insecurity (FI), water insecurity (WI), and sanitation insecurity (SI) with HIV vulnerabilities (transactional sex [TS], intimate partner violence [IPV], sexual relationship power [SRP], and preexposure prophylaxis [PrEP] awareness and acceptability). Results Among participants (n = 597; mean age: 20.13 years; standard deviation = 2.5), in adjusted analyses, SI and WI were associated with increased TS. Increased cumulative EWEs and eco-anxiety were associated with increased IPV. EWE frequency, FI, and SI were associated with reduced SRP. EWE frequency and SI were associated with reduced, and WI with increased, PrEP awareness. EWE frequency and SI were associated with PrEP acceptability. Conclusion Resource scarcities and EWEs were associated with HIV vulnerabilities and PrEP acceptability among AGYW.